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Cubital Tunnel Syndrome: Does a Consensus Exist for Diagnosis?
Devin W Collins1, David Rehak2, Alex Dawes3
1Hand and Upper Extremity Department, Florida Orthopaedic Institute, Tampa Bay, FL; Hughston Clinic, Columbus, GA.
The Journal of Hand Surgery
|July 9, 2023
Summary
Experts reached a consensus on key clinical criteria for diagnosing cubital tunnel syndrome (CuTS). This Delphi method study identified essential signs and symptoms for accurate CuTS diagnosis.
Area of Science:
- Orthopedics
- Neurology
- Surgical Research
Background:
- Cubital tunnel syndrome (CuTS) is a prevalent upper extremity compressive neuropathy.
- Accurate diagnosis is crucial for effective management and patient outcomes.
Purpose of the Study:
- To establish expert consensus on clinical diagnostic criteria for CuTS using the Delphi method.
- To identify key indicators for further validation in CuTS diagnosis.
Main Methods:
- A Delphi method approach involving 12 hand and upper-extremity surgeons.
- Panelists ranked the diagnostic importance of 55 CuTS-related clinical items.
- Statistical analysis, including Cronbach's alpha, assessed consensus and reliability.
Main Results:
- High inter-rater reliability was achieved (Cronbach's α = 0.963).
- Consensus was reached on six key diagnostic criteria for CuTS.
- These include sensory changes, provocative tests, Tinel sign, motor deficits, two-point discrimination, and contralateral symptom comparison.
Conclusions:
- The study achieved expert consensus on crucial clinical criteria for diagnosing CuTS.
- These criteria provide a foundation for a standardized diagnostic approach.
- Further validation and weighting are required to develop a formal diagnostic scale for CuTS.
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